4. Use in gynecology and urology

4.1 In gynecology

The healthy vaginal flora of a woman of childbearing age is dominated by lactobacilli, which play a major role in balancing this microbiota. These lactobacilli, as their name suggests, produce lactic acid in its two racemic forms D and L, either directly from glycogen, or from oligosaccharides (maltose, maltotriose, maltotetraose) produced by the action on glycogen of an α-amylase from the vaginal epithelium.

When the vaginal ecosystem is normal, physiological concentrations of these two racemic forms of lactic acid range from 55 to 110 mM, with a pH below 4.5. Lactic acid is then in proton form, and it is in this form that levogyric lactic acid is the most microbicidal: bactericidal against 17 species associated with vaginosis